HMH Ocean University Medical Center — Pricing

792 procedures published in this hospital's Machine-Readable File (MRF) — 771 with a comparable price, 21 with per-payer negotiated rates only. Prices shown are pre-insurance; actual cost depends on your plan, Medicare/Medicaid coverage, or cash-pay discounts.

Procedures published 792
Lowest published price $1,649
Average published price $19,400
Highest published price $311,271

Gross charges are the hospital's listed price — almost no one pays this amount. Your actual cost depends on your insurance plan. Use the cash price (when shown) as a guide for what uninsured patients are charged, and contact the hospital or your insurer for a personalized cost estimate.

Showing all 792 procedures

Published charges

Showing all 771 procedures with a comparable published price (gross, cash, or insurance-negotiated median), sorted highest to lowest. Green = this hospital prices below the median; amber = above.

Across 130 procedures, this hospital's negotiated rates average ≈141% of what Medicare pays.

DRG Description Published price Cash price vs. NJ median vs. National median vs Medicare
018 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL IMMUNOTHERAPY $311,271 $311,271 $391,526 −20% $498,715 −38% —
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $232,493 $232,493 $338,950 −31% $431,073 −46% —
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT $195,801 $195,801 $236,577 −17% $306,087 −36% —
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $176,890 $176,890 $260,247 −32% $371,366 −52% —
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $116,625 $116,625 $170,027 −31% $245,241 −52% —
014 ALLOGENEIC BONE MARROW TRANSPLANT $108,138 $108,138 $122,488 −12% $182,314 −41% —
007 Lung transplant $107,866 $107,866 $126,907 −15% $170,608 −37% —
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $90,953 $90,953 $114,404 −20% $169,977 −46% —
212 Concomitant Aortic and Mitral Valve Procedures $89,915 $89,915 $102,715 −12% $171,338 −48% —
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $87,897 $87,897 $128,144 −31% $159,181 −45% —
215 Other heart assist system implant $87,446 $87,446 $116,471 −25% $191,314 −54% —
426 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $86,461 $86,461 $99,176 −13% $142,326 −39% —
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $79,657 $79,657 $113,415 −30% $175,437 −55% —
850 ACUTE LEUKEMIA WITH OTHER PROCEDURES $76,032 $76,032 $77,091 −1% $121,563 −37% —
231 CORONARY BYPASS WITH PTCA WITH MCC $69,941 $69,941 $105,048 −33% $146,474 −52% —
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC $69,902 $69,902 $111,108 −37% $151,029 −54% —
429 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC $68,841 $68,841 $72,481 −5% $120,174 −43% —
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $66,534 $66,534 $96,999 −31% $134,914 −51% —
010 Pancreas transplant $65,807 $65,807 $69,287 −5% $99,940 −34% —
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS $65,430 $65,430 $69,210 −5% $105,228 −38% —
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITH MCC $64,514 $64,514 $99,484 −35% $138,868 −54% —
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $63,863 $63,863 $88,104 −28% $143,242 −55% —
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $61,607 $61,607 $96,002 −36% $120,587 −49% —
427 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC $58,624 $58,624 $60,256 −3% $121,728 −52% —
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $58,329 $58,329 $62,554 −7% $131,961 −56% —
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $57,417 $57,417 $81,678 −30% $138,008 −58% ≈135% of Medicare
955 Craniotomy for multiple significant trauma $56,359 $56,359 $59,339 −5% $105,612 −47% —
447 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $55,339 $55,339 $69,607 −20% $114,914 −52% —
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC $55,126 $55,126 $56,660 −3% $89,353 −38% —
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC $55,032 $55,032 $61,786 −11% $118,589 −54% —
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $53,378 $53,378 $56,462 −5% $116,058 −54% —
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $53,302 $53,302 $56,890 −6% $121,714 −56% —
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $52,199 $52,199 $76,100 −31% $109,331 −52% —
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR $51,127 $51,127 $56,010 −9% $117,280 −56% —
317 CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION $51,061 $51,061 $74,441 −31% $94,988 −46% —
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC $50,828 $50,828 $76,220 −33% $98,912 −49% —
461 Bilateral or multiple major joint procs of lower extremity w MCC $50,651 $50,651 $77,989 −35% $108,472 −53% —
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $50,419 $50,419 $53,665 −6% $106,238 −53% —
028 SPINAL PROCEDURES WITH MCC $50,178 $50,178 $74,391 −33% $95,858 −48% —
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC $49,819 $49,819 $70,720 −30% $98,260 −49% —
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC $49,819 $49,819 $61,708 −19% $81,176 −39% —
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC $49,446 $49,446 $71,503 −31% $113,855 −57% —
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC $49,104 $49,104 $73,928 −34% $92,238 −47% —
790 Extreme immaturity or respiratory distress syndrome, neonate $49,067 $49,067 $71,534 −31% $80,018 −39% —
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC $48,566 $48,566 $67,362 −28% $112,062 −57% —
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $48,056 $48,056 $71,838 −33% $96,192 −50% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $47,371 $47,371 $69,568 −32% $107,355 −56% —
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR $47,088 $47,088 $74,760 −37% $106,778 −56% —
653 MAJOR BLADDER PROCEDURES WITH MCC $46,011 $46,011 $62,070 −26% $97,046 −53% —
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC $45,621 $45,621 $57,383 −20% $101,235 −55% —
834 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC $45,621 $45,621 $46,891 −3% $76,583 −40% —
428 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC $45,429 $45,429 $66,231 −31% $105,899 −57% —
430 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC $45,152 $45,152 $65,827 −31% $93,783 −52% —
008 Simultaneous pancreas/kidney transplant $44,909 $44,909 $53,926 −17% $86,459 −48% —
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC $44,807 $44,807 $69,661 −36% $94,927 −53% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $44,578 $44,578 $46,936 −5% $78,582 −43% —
011 Tracheostomy for face,mouth & neck diagnoses w MCC $44,536 $44,536 $46,225 −4% $86,953 −49% —
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC $44,531 $44,531 $46,886 −5% $82,527 −46% —
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITHOUT MCC $43,911 $43,911 $61,822 −29% $102,573 −57% —
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $43,717 $43,717 $47,356 −8% $102,177 −57% —
450 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $42,507 $42,507 $44,547 −5% $79,944 −47% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $42,366 $42,366 $59,897 −29% $99,423 −57% ≈119% of Medicare
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC $42,049 $42,049 $65,645 −36% $96,222 −56% ≈144% of Medicare
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $41,921 $41,921 $59,697 −30% $80,747 −48% —
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC $41,573 $41,573 $49,585 −16% $87,565 −53% —
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $41,328 $41,328 $43,716 −5% $70,735 −42% —
278 Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with MCC $41,296 $41,296 $43,480 −5% $84,861 −51% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $41,279 $41,279 $66,300 −38% $87,018 −53% ≈126% of Medicare
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $41,131 $41,131 $57,822 −29% $96,905 −58% —
245 AICD generator procedures $40,334 $40,334 $61,075 −34% $72,076 −44% —
471 CERVICAL SPINAL FUSION WITH MCC $40,091 $40,091 $58,448 −31% $92,515 −57% —
006 LIVER TRANSPLANT WITHOUT MCC $40,024 $40,024 $48,936 −18% $84,407 −53% —
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $39,416 $39,416 $53,961 −27% $88,691 −56% —
799 SPLENIC PROCEDURES WITH MCC $39,245 $39,245 $63,003 −38% $78,821 −50% —
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $39,237 $39,237 $54,442 −28% $86,390 −55% ≈138% of Medicare
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT W/O MCC $38,831 $38,831 $56,801 −32% $92,217 −58% —
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $38,623 $38,623 $58,079 −33% $80,885 −52% —
277 Cardiac Defibrillator Implant without MCC $38,395 $38,395 $49,595 −23% $91,329 −58% —
163 MAJOR CHEST PROCEDURES WITH MCC $38,043 $38,043 $54,801 −31% $88,341 −57% ≈133% of Medicare
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $38,027 $38,027 $40,443 −6% $71,551 −47% —
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC $37,906 $37,906 $54,333 −30% $90,331 −58% —
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $37,900 $37,900 $62,792 −40% $88,050 −57% ≈124% of Medicare
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $37,237 $37,237 $50,907 −27% $72,859 −49% —
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $37,015 $37,015 $44,319 −16% $76,954 −52% —
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $36,913 $36,913 $44,906 −18% $88,307 −58% —
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $36,568 $36,568 $37,586 −3% $68,847 −47% —
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC $36,257 $36,257 $46,152 −21% $75,585 −52% —
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $35,713 $35,713 $33,230 +7% $59,352 −40% —
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC $35,640 $35,640 $55,653 −36% $83,441 −57% —
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $35,208 $35,208 $52,759 −33% $82,561 −57% ≈122% of Medicare
323 Coronary Intravascular Lithotripsy with Intraluminal Device with MCC $35,156 $35,156 $55,014 −36% $88,049 −60% —
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $34,907 $34,907 $34,907 +0% $60,098 −42% —
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $34,588 $34,588 $50,459 −31% $68,659 −50% —
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $34,580 $34,580 $51,316 −33% $72,945 −53% ≈123% of Medicare
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $34,422 $34,422 $35,380 −3% $16,719 +106% —
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $34,341 $34,341 $42,533 −19% $83,065 −59% ≈127% of Medicare
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $33,940 $33,940 $46,520 −27% $82,247 −59% —
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC $33,921 $33,921 $41,582 −18% $66,853 −49% —
012 Tracheostomy for face,mouth & neck diagnoses w CC $33,871 $33,871 $35,828 −5% $73,029 −54% —
448 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $33,704 $33,704 $34,642 −3% $81,998 −59% —
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $33,571 $33,571 $48,943 −31% $72,011 −53% —
791 PREMATURITY WITH MAJOR PROBLEMS $33,509 $33,509 $45,159 −26% $39,563 −15% —
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $32,880 $32,880 $45,405 −28% $71,701 −54% —
739 Uterine,adnexa proc for non-ovarian/adnexal malig w MCC $32,857 $32,857 $47,902 −31% $57,521 −43% —
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $32,567 $32,567 $35,390 −8% $68,006 −52% —
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $32,500 $32,500 $47,381 −31% $61,832 −47% —
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $32,434 $32,434 $33,337 −3% $54,196 −40% —
402 SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL $32,290 $32,290 $33,189 −3% $75,492 −57% —
273 PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC $32,274 $32,274 $40,083 −19% $78,852 −59% —
034 CAROTID ARTERY STENT PROCEDURES WITH MCC $32,096 $32,096 $33,950 −5% $72,908 −56% —
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $31,901 $31,901 $34,783 −8% $62,961 −49% —
904 SKIN GRAFTS FOR INJURIES WITH CC/MCC $31,868 $31,868 $33,398 −5% $55,097 −42% —
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $31,779 $31,779 $48,736 −35% $72,782 −56% —
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $31,549 $31,549 $35,111 −10% $75,103 −58% —
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $31,378 $31,378 $47,667 −34% $74,755 −58% —
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $31,134 $31,134 $44,874 −31% $74,257 −58% —
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $30,885 $30,885 $46,834 −34% $60,861 −49% —
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $30,115 $30,115 $36,817 −18% $62,524 −52% —
335 PERITONEAL ADHESIOLYSIS WITH MCC $29,906 $29,906 $46,502 −36% $71,755 −58% —
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $29,588 $29,588 $30,575 −3% $59,425 −50% —
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $29,586 $29,586 $29,586 +0% $57,855 −49% —
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $29,581 $29,581 $31,290 −5% $64,776 −54% —
265 AICD lead procedures $29,443 $29,443 $31,144 −5% $56,695 −48% —
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $29,311 $29,311 $35,670 −18% $70,540 −58% —
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC $29,139 $29,139 $48,061 −39% $62,404 −53% —
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $29,131 $29,131 $29,942 −3% $50,919 −43% —
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC $29,058 $29,058 $43,922 −34% $56,964 −49% —
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC $28,919 $28,919 $31,947 −9% $68,399 −58% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $28,910 $28,910 $38,991 −26% $65,383 −56% —
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $28,899 $28,899 $42,905 −33% $59,207 −51% —
264 Other circulatory system O.R. procedures $28,848 $28,848 $29,651 −3% $51,953 −44% —
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $28,661 $28,661 $30,833 −7% $56,242 −49% —
332 RECTAL RESECTION WITH MCC $28,630 $28,630 $29,427 −3% $58,125 −51% —
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $28,598 $28,598 $30,877 −7% $49,065 −42% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $28,429 $28,429 $30,072 −5% $71,014 −60% ≈133% of Medicare
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $28,385 $28,385 $30,024 −5% $62,269 −54% —
665 PROSTATECTOMY WITH MCC $28,340 $28,340 $41,317 −31% $54,072 −48% —
252 OTHER VASCULAR PROCEDURES WITH MCC $28,314 $28,314 $42,633 −34% $68,508 −59% ≈114% of Medicare
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $28,271 $28,271 $42,906 −34% $68,880 −59% ≈123% of Medicare
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $28,114 $28,114 $38,294 −27% $67,901 −59% —
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $27,997 $27,997 $43,918 −36% $70,132 −60% ≈121% of Medicare
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $27,705 $27,705 $28,756 −4% $64,152 −57% —
037 EXTRACRANIAL PROCEDURES WITH MCC $27,410 $27,410 $28,173 −3% $64,749 −58% —
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $27,253 $27,253 $28,012 −3% $52,908 −48% —
469 Major joint replacement or reattachment of lower extremity w MCC $26,979 $26,979 $33,894 −20% $65,254 −59% —
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $26,902 $26,902 $38,910 −31% $54,129 −50% —
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $26,891 $26,891 $28,474 −6% $64,465 −58% —
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $26,571 $26,571 $27,579 −4% $64,956 −59% —
279 Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures without MCC $26,448 $26,448 $40,209 −34% $57,277 −54% —
324 Coronary Intravascular Lithotripsy with Intraluminal Device without MCC $26,371 $26,371 $27,766 −5% $66,819 −61% —
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $26,321 $26,321 $27,054 −3% $49,710 −47% ≈159% of Medicare
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC $26,250 $26,250 $27,638 −5% $44,472 −41% —
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $26,197 $26,197 $26,927 −3% $51,142 −49% —
500 SOFT TISSUE PROCEDURES WITH MCC $26,154 $26,154 $27,145 −4% $57,479 −54% —
274 PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC $25,760 $25,760 $37,451 −31% $65,573 −61% —
662 MINOR BLADDER PROCEDURES WITH MCC $25,748 $25,748 $30,960 −17% $54,483 −53% —
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $25,639 $25,639 $37,378 −31% $65,325 −61% —
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $25,524 $25,524 $26,998 −5% $62,821 −59% —
451 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $25,471 $25,471 $26,180 −3% $65,216 −61% —
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC $25,453 $25,453 $27,771 −8% $53,817 −53% —
652 Kidney transplant $25,350 $25,350 $27,280 −7% $54,720 −54% —
173 Ultrasound Accelerated and other Thrombolysis with Principal Diagnosis Pulmonary Embolism $25,327 $25,327 $32,419 −22% $53,555 −53% —
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $25,245 $25,245 $34,191 −26% $63,475 −60% —
570 SKIN DEBRIDEMENT WITH MCC $24,845 $24,845 $26,159 −5% $52,435 −53% —
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $24,647 $24,647 $25,951 −5% $46,402 −47% —
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $24,337 $24,337 $25,014 −3% $54,313 −55% —
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $24,274 $24,274 $36,997 −34% $63,984 −62% ≈129% of Medicare
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $24,208 $24,208 $26,562 −9% $60,140 −60% —
668 TRANSURETHRAL PROCEDURES WITH MCC $24,070 $24,070 $25,343 −5% $47,277 −49% —
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $24,057 $24,057 $35,073 −31% $67,764 −64% ≈125% of Medicare
800 SPLENIC PROCEDURES WITH CC $24,050 $24,050 $25,439 −5% $49,184 −51% —
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $24,036 $24,036 $25,425 −5% $54,475 −56% —
472 CERVICAL SPINAL FUSION WITH CC $23,913 $23,913 $25,060 −5% $59,537 −60% —
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC $23,664 $23,664 $24,323 −3% $58,968 −60% —
462 Bilateral or multiple major joint procs of lower extremity w/o MCC $23,637 $23,637 $29,422 −20% $56,758 −58% —
325 Coronary Intravascular Lithotripsy without Intraluminal Device $23,623 $23,623 $24,988 −5% $53,551 −56% —
510 Shoulder,elbow or forearm proc,exc major joint proc w MCC $23,590 $23,590 $24,247 −3% $49,055 −52% —
321 Percutaneous Cardiovascular Procedures with Intraluminal Device with MMC or 4+ Arteries/Intraluminal Devices $23,497 $23,497 $24,151 −3% $74,274 −68% ≈114% of Medicare
654 MAJOR BLADDER PROCEDURES WITH CC $23,293 $23,293 $24,176 −4% $53,868 −57% —
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $23,180 $23,180 $24,059 −4% $58,043 −60% —
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $23,156 $23,156 $32,590 −29% $48,907 −53% —
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC $22,585 $22,585 $23,780 −5% $48,358 −53% —
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $22,545 $22,545 $22,859 −1% $45,497 −50% —
619 O.R. PROCEDURES FOR OBESITY WITH MCC $22,504 $22,504 $23,568 −5% $44,973 −50% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $22,423 $22,423 $23,718 −5% $43,491 −48% —
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $22,313 $22,313 $28,045 −20% $57,963 −62% —
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $22,240 $22,240 $24,914 −11% $44,839 −50% —
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $22,151 $22,151 $22,768 −3% $52,405 −58% ≈134% of Medicare
263 VEIN LIGATION AND STRIPPING $22,137 $22,137 $23,200 −5% $44,938 −51% —
849 Radiotherapy $22,046 $22,046 $22,353 −1% $37,862 −42% —
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $21,978 $21,978 $22,590 −3% $45,432 −52% —
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $21,900 $21,900 $22,509 −3% $40,947 −47% —
013 Tracheostomy for face,mouth & neck diagnoses w/o CC/MCC $21,872 $21,872 $22,177 −1% $45,290 −52% —
503 FOOT PROCEDURES WITH MCC $21,844 $21,844 $23,106 −5% $43,901 −50% —
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $21,822 $21,822 $29,424 −26% $40,277 −46% —
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC $21,652 $21,652 $22,797 −5% $54,929 −61% —
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $21,596 $21,596 $21,896 −1% $43,697 −51% —
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC $21,366 $21,366 $21,960 −3% $41,703 −49% —
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $21,330 $21,330 $22,354 −5% $48,094 −56% ≈125% of Medicare
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $21,078 $21,078 $21,877 −4% $38,878 −46% —
253 OTHER VASCULAR PROCEDURES WITH CC $21,072 $21,072 $22,753 −7% $53,746 −61% —
483 MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES $21,032 $21,032 $22,247 −5% $57,149 −63% —
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $20,924 $20,924 $18,088 +16% $36,097 −42% —
545 CONNECTIVE TISSUE DISORDERS WITH MCC $20,856 $20,856 $21,147 −1% $39,657 −47% —
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC $20,840 $20,840 $22,044 −5% $46,659 −55% —
164 MAJOR CHEST PROCEDURES WITH CC $20,775 $20,775 $21,353 −3% $53,141 −61% —
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $20,668 $20,668 $20,668 +0% $39,409 −48% ≈142% of Medicare
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC $20,652 $20,652 $21,745 −5% $55,162 −63% —
397 Appendix Procedures with MCC $20,451 $20,451 $21,532 −5% $52,319 −61% —
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC $20,369 $20,369 $20,936 −3% $52,332 −61% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $20,219 $20,219 $20,782 −3% $11,633 +74% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $20,208 $20,208 $21,375 −5% $51,985 −61% —
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $20,041 $20,041 $20,599 −3% $54,824 −63% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $19,963 $19,963 $20,519 −3% $46,591 −57% —
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC $19,901 $19,901 $20,655 −4% $40,065 −50% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $19,817 $19,817 $28,417 −30% $56,394 −65% ≈145% of Medicare
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $19,786 $19,786 $20,337 −3% $47,583 −58% —
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC $19,786 $19,786 $20,337 −3% $39,093 −49% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $19,615 $19,615 $28,596 −31% $52,313 −63% ≈135% of Medicare
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC $19,540 $19,540 $20,281 −4% $50,624 −61% —
347 ANAL AND STOMAL PROCEDURES WITH MCC $19,535 $19,535 $20,663 −5% $40,548 −52% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $19,509 $19,509 $20,052 −3% $58,832 −67% ≈135% of Medicare
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC $19,478 $19,478 $20,508 −5% $47,546 −59% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $19,302 $19,302 $20,417 −5% $50,139 −62% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $19,150 $19,150 $19,683 −3% $36,237 −47% —
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC $19,106 $19,106 $20,257 −6% $36,080 −47% —
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC $19,088 $19,088 $19,811 −4% $51,339 −63% —
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $19,053 $19,053 $27,750 −31% $49,631 −62% —
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $18,935 $18,935 $19,273 −2% $37,080 −49% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $18,903 $18,903 $19,811 −5% $36,334 −48% ≈134% of Medicare
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $18,846 $18,846 $19,842 −5% $39,253 −52% —
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC $18,810 $18,810 $19,713 −5% $43,586 −57% —
035 CAROTID ARTERY STENT PROCEDURES WITH CC $18,776 $18,776 $19,487 −4% $46,430 −60% —
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $18,703 $18,703 $19,224 −3% $37,064 −50% —
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC $18,639 $18,639 $19,158 −3% $38,998 −52% —
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $18,639 $18,639 $19,533 −5% $44,989 −59% —
113 ORBITAL PROCEDURES WITH CC/MCC $18,625 $18,625 $19,331 −4% $35,642 −48% —
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $18,594 $18,594 $19,668 −5% $50,011 −63% ≈120% of Medicare
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $18,587 $18,587 $19,570 −5% $48,682 −62% —
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $18,563 $18,563 $19,545 −5% $45,059 −59% —
709 PENIS PROCEDURES WITH CC/MCC $18,547 $18,547 $19,437 −5% $34,535 −46% —
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $18,426 $18,426 $18,682 −1% $44,053 −58% —
030 SPINAL PROCEDURES WITHOUT CC/MCC $18,368 $18,368 $18,879 −3% $45,818 −60% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $18,268 $18,268 $19,498 −6% $44,600 −59% ≈141% of Medicare
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $18,153 $18,153 $18,841 −4% $38,382 −53% —
935 Non-extensive burns $18,128 $18,128 $18,633 −3% $29,458 −38% —
906 Hand procedures for injuries $18,014 $18,014 $18,264 −1% $31,520 −43% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $17,984 $17,984 $19,259 −7% $41,900 −57% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $17,905 $17,905 $18,584 −4% $37,902 −53% —
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $17,806 $17,806 $19,205 −7% $44,553 −60% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $17,774 $17,774 $18,627 −5% $38,357 −54% ≈135% of Medicare
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $17,733 $17,733 $18,227 −3% $34,900 −49% —
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $17,711 $17,711 $18,382 −4% $31,044 −43% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $17,698 $17,698 $18,191 −3% $36,850 −52% —
835 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC $17,629 $17,629 $17,874 −1% $35,569 −50% —
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC $17,628 $17,628 $18,560 −5% $40,232 −56% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $17,627 $17,627 $18,559 −5% $45,622 −61% —
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $17,594 $17,594 $18,686 −6% $37,654 −53% —
333 RECTAL RESECTION WITH CC $17,542 $17,542 $18,469 −5% $34,352 −49% —
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $17,505 $17,505 $18,345 −5% $46,477 −62% —
595 MAJOR SKIN DISORDERS WITH MCC $17,457 $17,457 $17,943 −3% $31,785 −45% —
336 PERITONEAL ADHESIOLYSIS WITH CC $17,434 $17,434 $21,904 −20% $49,470 −65% ≈129% of Medicare
374 DIGESTIVE MALIGNANCY WITH MCC $17,427 $17,427 $18,263 −5% $38,885 −55% ≈154% of Medicare
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $17,427 $17,427 $17,669 −1% $38,420 −55% —
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $17,400 $17,400 $17,642 −1% $56,519 −69% ≈125% of Medicare
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC $17,356 $17,356 $19,834 −12% $35,686 −51% —
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $17,304 $17,304 $17,896 −3% $46,066 −62% —
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $17,254 $17,254 $17,735 −3% $32,483 −47% —
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC $17,145 $17,145 $17,623 −3% $41,651 −59% —
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $17,126 $17,126 $17,775 −4% $51,172 −67% ≈132% of Medicare
592 SKIN ULCERS WITH MCC $16,972 $16,972 $17,616 −4% $32,662 −48% —
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC $16,899 $16,899 $17,710 −5% $34,089 −50% —
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $16,740 $16,740 $17,206 −3% $30,661 −45% —
539 OSTEOMYELITIS WITH MCC $16,692 $16,692 $17,157 −3% $33,746 −51% —
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $16,649 $16,649 $17,112 −3% $41,660 −60% —
548 SEPTIC ARTHRITIS WITH MCC $16,628 $16,628 $17,091 −3% $31,019 −46% —
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC $16,611 $16,611 $17,073 −3% $30,940 −46% —
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $16,604 $16,604 $18,104 −8% $45,817 −64% —
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $16,494 $16,494 $16,953 −3% $44,363 −63% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $16,492 $16,492 $17,364 −5% $43,524 −62% ≈150% of Medicare
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $16,480 $16,480 $17,271 −5% $29,109 −43% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $16,418 $16,418 $16,875 −3% $35,714 −54% ≈145% of Medicare
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $16,407 $16,407 $17,194 −5% $35,139 −53% —
100 SEIZURES WITH MCC $16,386 $16,386 $17,172 −5% $35,194 −53% —
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC $16,384 $16,384 $16,841 −3% $29,633 −45% —
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $16,327 $16,327 $17,190 −5% $43,398 −62% —
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $16,285 $16,285 $17,146 −5% $43,800 −63% —
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $16,275 $16,275 $17,136 −5% $43,775 −63% —
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC $16,222 $16,222 $16,673 −3% $41,520 −61% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $16,195 $16,195 $16,645 −3% $35,237 −54% ≈139% of Medicare
511 Shoulder,elbow or forearm proc,exc major joint proc w CC $16,187 $16,187 $16,964 −5% $43,538 −63% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $16,170 $16,170 $16,783 −4% $36,933 −56% ≈129% of Medicare
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $16,139 $16,139 $16,589 −3% $35,014 −54% —
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC $16,130 $16,130 $16,579 −3% $29,524 −45% —
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC $16,128 $16,128 $16,902 −5% $33,050 −51% —
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC $16,017 $16,017 $16,240 −1% $43,080 −63% —
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC $15,997 $15,997 $16,604 −4% $36,202 −56% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $15,943 $15,943 $16,387 −3% $42,881 −63% —
380 COMPLICATED PEPTIC ULCER WITH MCC $15,883 $15,883 $16,722 −5% $36,641 −57% —
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $15,788 $15,788 $16,227 −3% $33,165 −52% —
711 TESTES PROCEDURES WITH CC/MCC $15,770 $15,770 $16,209 −3% $34,852 −55% —
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $15,662 $15,662 $16,567 −5% $42,126 −63% —
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $15,662 $15,662 $16,098 −3% $35,459 −56% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $15,627 $15,627 $16,062 −3% $36,280 −57% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $15,603 $15,603 $16,037 −3% $32,399 −52% ≈144% of Medicare
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $15,581 $15,581 $16,015 −3% $32,204 −52% ≈153% of Medicare
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $15,564 $15,564 $15,997 −3% $32,981 −53% —
470 Major joint replacement or reattachment of lower extremity w/o MCC $15,562 $15,562 $16,152 −4% $49,197 −68% —
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC $15,562 $15,562 $16,152 −4% $45,963 −66% —
196 INTERSTITIAL LUNG DISEASE WITH MCC $15,551 $15,551 $16,297 −5% $30,766 −49% ≈136% of Medicare
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $15,394 $15,394 $15,978 −4% $35,114 −56% —
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC $15,385 $15,385 $15,813 −3% $41,380 −63% —
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $15,321 $15,321 $15,902 −4% $30,974 −51% —
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC $15,315 $15,315 $15,528 −1% $32,538 −53% —
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $15,302 $15,302 $15,515 −1% $22,698 −33% —
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $15,236 $15,236 $15,813 −4% $29,609 −49% —
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $15,204 $15,204 $16,156 −6% $28,375 −46% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $15,176 $15,176 $15,904 −5% $30,394 −50% ≈129% of Medicare
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC $15,130 $15,130 $15,340 −1% $40,694 −63% —
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $15,089 $15,089 $15,661 −4% $40,583 −63% —
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $15,081 $15,081 $15,653 −4% $40,563 −63% —
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC $15,077 $15,077 $15,497 −3% $40,552 −63% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $15,060 $15,060 $15,782 −5% $37,950 −60% ≈137% of Medicare
919 COMPLICATIONS OF TREATMENT WITH MCC $15,051 $15,051 $15,622 −4% $29,031 −48% ≈133% of Medicare
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $15,046 $15,046 $15,616 −4% $36,375 −59% ≈146% of Medicare
740 Uterine,adnexa proc for non-ovarian/adnexal malig w CC $15,008 $15,008 $15,426 −3% $36,597 −59% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $15,007 $15,007 $15,800 −5% $37,842 −60% ≈133% of Medicare
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $14,933 $14,933 $15,500 −4% $29,476 −49% —
322 Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC $14,933 $14,933 $15,140 −1% $54,772 −73% ≈141% of Medicare
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC $14,895 $14,895 $15,683 −5% $40,063 −63% —
789 Neonates, died or transferred to another acute care facility $14,878 $14,878 $15,085 −1% $14,284 +4% —
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $14,828 $14,828 $15,241 −3% $24,836 −40% —
501 SOFT TISSUE PROCEDURES WITH CC $14,730 $14,730 $15,581 −5% $37,975 −61% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $14,699 $14,699 $15,108 −3% $48,680 −70% ≈133% of Medicare
896 Alcohol/drug abuse or dependence w/o rehabilitation therapy w MCC $14,698 $14,698 $15,107 −3% $30,275 −51% ≈112% of Medicare
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC $14,692 $14,692 $15,101 −3% $33,564 −56% —
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $14,657 $14,657 $15,065 −3% $31,909 −54% —
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $14,634 $14,634 $15,336 −5% $36,242 −60% —
199 PNEUMOTHORAX WITH MCC $14,570 $14,570 $15,123 −4% $31,491 −54% —
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $14,508 $14,508 $14,911 −3% $35,673 −59% —
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC $14,507 $14,507 $15,203 −5% $39,018 −63% —
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $14,499 $14,499 $15,049 −4% $29,558 −51% —
509 Arthroscopy $14,499 $14,499 $14,903 −3% $25,994 −44% —
597 MALIGNANT BREAST DISORDERS WITH MCC $14,499 $14,499 $14,903 −3% $31,846 −54% —
504 FOOT PROCEDURES WITH CC $14,485 $14,485 $14,889 −3% $36,598 −60% —
505 FOOT PROCEDURES WITHOUT CC/MCC $14,485 $14,485 $14,889 −3% $31,716 −54% —
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC $14,454 $14,454 $14,856 −3% $34,264 −58% —
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC $14,439 $14,439 $14,950 −3% $38,836 −63% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $14,427 $14,427 $15,120 −5% $31,758 −55% —
180 RESPIRATORY NEOPLASMS WITH MCC $14,426 $14,426 $14,973 −4% $36,658 −61% ≈136% of Medicare
070 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC $14,352 $14,352 $14,751 −3% $30,814 −53% —
915 ALLERGIC REACTIONS WITH MCC $14,344 $14,344 $14,888 −4% $30,944 −54% —
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $14,329 $14,329 $14,728 −3% $32,839 −56% —
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $14,270 $14,270 $14,811 −4% $29,826 −52% —
671 URETHRAL PROCEDURES WITH CC/MCC $14,227 $14,227 $14,623 −3% $27,233 −48% —
075 VIRAL MENINGITIS WITH CC/MCC $14,216 $14,216 $14,216 +0% $29,853 −52% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $14,163 $14,163 $14,843 −5% $38,094 −63% —
551 MEDICAL BACK PROBLEMS WITH MCC $14,084 $14,084 $14,618 −4% $31,086 −55% —
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $14,040 $14,040 $14,431 −3% $43,266 −68% —
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $13,979 $13,979 $14,368 −3% $29,729 −53% —
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $13,952 $13,952 $14,340 −3% $28,578 −51% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $13,944 $13,944 $14,613 −5% $29,409 −53% —
444 DISORDERS OF THE BILIARY TRACT WITH MCC $13,903 $13,903 $14,290 −3% $31,128 −55% ≈155% of Medicare
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $13,874 $13,874 $14,260 −3% $30,058 −54% ≈140% of Medicare
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC $13,822 $13,822 $14,485 −5% $29,916 −54% —
571 SKIN DEBRIDEMENT WITH CC $13,819 $13,819 $14,343 −4% $34,901 −60% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $13,785 $13,785 $14,169 −3% $25,208 −45% ≈129% of Medicare
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $13,784 $13,784 $14,167 −3% $33,607 −59% —
116 INTRAOCULAR PROCEDURES WITH CC/MCC $13,772 $13,772 $14,294 −4% $28,103 −51% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $13,769 $13,769 $14,152 −3% $30,930 −55% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $13,732 $13,732 $14,391 −5% $32,502 −58% ≈141% of Medicare
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC $13,722 $13,722 $13,994 −2% $27,548 −50% —
334 RECTAL RESECTION WITHOUT CC/MCC $13,690 $13,690 $14,071 −3% $32,213 −58% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $13,688 $13,688 $14,069 −3% $42,119 −68% ≈136% of Medicare
643 ENDOCRINE DISORDERS WITH MCC $13,679 $13,679 $14,060 −3% $32,996 −59% ≈137% of Medicare
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $13,668 $13,668 $14,049 −3% $32,689 −58% ≈137% of Medicare
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $13,627 $13,627 $14,006 −3% $44,117 −69% ≈132% of Medicare
905 SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC $13,604 $13,604 $13,793 −1% $25,197 −46% —
666 PROSTATECTOMY WITH CC $13,596 $13,596 $14,112 −4% $30,016 −55% —
583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC $13,558 $13,558 $13,936 −3% $31,566 −57% —
801 SPLENIC PROCEDURES WITHOUT CC/MCC $13,550 $13,550 $14,064 −4% $28,634 −53% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $13,548 $13,548 $14,198 −5% $28,967 −53% ≈139% of Medicare
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $13,534 $13,534 $13,910 −3% $28,134 −52% ≈139% of Medicare
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $13,523 $13,523 $14,036 −4% $30,910 −56% —
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $13,516 $13,516 $13,893 −3% $36,333 −63% —
157 DENTAL AND ORAL DISEASES WITH MCC $13,515 $13,515 $13,892 −3% $27,457 −51% —
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $13,423 $13,423 $13,610 −1% $24,465 −45% —
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC $13,417 $13,417 $13,926 −4% $27,168 −51% —
385 INFLAMMATORY BOWEL DISEASE WITH MCC $13,411 $13,411 $14,054 −5% $26,020 −48% —
913 TRAUMATIC INJURY WITH MCC $13,357 $13,357 $13,729 −3% $24,198 −45% —
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $13,351 $13,351 $13,351 +0% $25,731 −48% ≈153% of Medicare
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $13,342 $13,342 $13,714 −3% $31,840 −58% ≈131% of Medicare
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $13,337 $13,337 $14,108 −5% $27,118 −51% —
038 EXTRACRANIAL PROCEDURES WITH CC $13,299 $13,299 $13,669 −3% $35,770 −63% —
606 MINOR SKIN DISORDERS WITH MCC $13,291 $13,291 $13,661 −3% $25,434 −48% —
512 Shoulder,elbow or forearm proc,exc major joint proc w/o CC/MCC $13,270 $13,270 $13,640 −3% $35,692 −63% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $13,230 $13,230 $13,598 −3% $35,584 −63% —
620 O.R. PROCEDURES FOR OBESITY WITH CC $13,181 $13,181 $14,418 −9% $35,453 −63% —
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC $13,169 $13,169 $13,535 −3% $33,984 −61% —
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $13,152 $13,152 $13,518 −3% $35,375 −63% —
183 MAJOR CHEST TRAUMA WITH MCC $13,101 $13,101 $13,466 −3% $28,924 −55% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $13,094 $13,094 $13,458 −3% $39,747 −67% —
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $13,043 $13,043 $13,406 −3% $33,490 −61% —
186 PLEURAL EFFUSION WITH MCC $13,041 $13,041 $13,404 −3% $32,468 −60% —
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $13,014 $13,014 $13,487 −4% $29,371 −56% —
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC $12,978 $12,978 $13,339 −3% $34,906 −63% —
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $12,952 $12,952 $13,312 −3% $32,936 −61% ≈137% of Medicare
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $12,942 $12,942 $13,302 −3% $31,059 −58% —
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC $12,920 $12,920 $13,279 −3% $32,490 −60% —
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $12,897 $12,897 $13,256 −3% $41,380 −69% —
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC $12,802 $12,802 $13,417 −5% $34,434 −63% —
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $12,791 $12,791 $13,276 −4% $28,646 −55% —
813 Coagulation disorders $12,777 $12,777 $13,132 −3% $30,128 −58% ≈137% of Medicare
669 TRANSURETHRAL PROCEDURES WITH CC $12,773 $12,773 $13,128 −3% $34,354 −63% —
077 HYPERTENSIVE ENCEPHALOPATHY WITH MCC $12,763 $12,763 $13,118 −3% $24,036 −47% —
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC $12,759 $12,759 $13,114 −3% $25,484 −50% —
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $12,757 $12,757 $13,241 −4% $28,252 −55% ≈148% of Medicare
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $12,670 $12,670 $13,340 −5% $36,239 −65% —
115 Extraocular procedures except orbit $12,636 $12,636 $13,243 −5% $24,879 −49% —
663 MINOR BLADDER PROCEDURES WITH CC $12,607 $12,607 $13,212 −5% $29,924 −58% —
945 REHABILITATION WITH CC/MCC $12,599 $12,599 $12,775 −1% $23,834 −47% —
533 FRACTURES OF FEMUR WITH MCC $12,586 $12,586 $12,936 −3% $25,945 −51% —
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC $12,527 $12,527 $12,876 −3% $33,694 −63% —
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC $12,520 $12,520 $12,869 −3% $30,972 −60% —
398 Appendix Procedures without MCC/CC $12,490 $12,490 $12,663 −1% $39,107 −68% —
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC $12,462 $12,462 $12,810 −3% $24,229 −49% —
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $12,457 $12,457 $12,930 −4% $27,279 −54% —
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC $12,427 $12,427 $13,023 −5% $33,424 −63% —
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $12,418 $12,418 $12,763 −3% $33,792 −63% —
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC $12,414 $12,414 $12,884 −4% $35,528 −65% —
682 RENAL FAILURE WITH MCC $12,396 $12,396 $12,741 −3% $27,854 −55% ≈136% of Medicare
710 PENIS PROCEDURES WITHOUT CC/MCC $12,392 $12,392 $12,737 −3% $23,814 −48% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $12,381 $12,381 $12,726 −3% $25,854 −52% —
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $12,373 $12,373 $12,842 −4% $29,484 −58% —
506 Major thumb or joint procedures $12,373 $12,373 $12,842 −4% $28,983 −57% —
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC $12,359 $12,359 $12,703 −3% $24,450 −49% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC $12,320 $12,320 $12,912 −5% $33,137 −63% —
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $12,287 $12,287 $12,753 −4% $31,062 −60% —
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $12,263 $12,263 $12,604 −3% $28,140 −56% —
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC $12,236 $12,236 $12,700 −4% $32,911 −63% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $12,184 $12,184 $12,888 −5% $7,961 +53% —
865 VIRAL ILLNESS WITH MCC $12,182 $12,182 $12,521 −3% $26,088 −53% —
693 URINARY STONES WITH MCC $12,136 $12,136 $12,474 −3% $22,525 −46% —
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $12,132 $12,132 $12,592 −4% $28,780 −58% ≈138% of Medicare
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC $12,128 $12,128 $12,466 −3% $25,152 −52% —
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $12,128 $12,128 $12,466 −3% $25,786 −53% —
602 CELLULITIS WITH MCC $12,126 $12,126 $12,464 −3% $29,347 −59% ≈136% of Medicare
562 Fx, sprn, strn & disl except femur, hip, pelvis & thigh w MCC $12,079 $12,079 $12,416 −3% $29,211 −59% —
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC $12,071 $12,071 $12,529 −4% $25,149 −52% —
621 O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC $12,065 $12,065 $12,523 −4% $32,451 −63% —
637 DIABETES WITH MCC $12,020 $12,020 $12,597 −5% $28,819 −58% ≈138% of Medicare
067 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC $12,008 $12,008 $12,175 −1% $24,941 −52% —
895 Alcohol/drug abuse or dependence w rehabilitation therapy $11,951 $11,951 $12,117 −1% $21,986 −46% —
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC $11,935 $11,935 $12,387 −4% $29,663 −60% —
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $11,901 $11,901 $12,232 −3% $22,525 −47% —
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $11,879 $11,879 $12,424 −4% $25,243 −53% —
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC $11,829 $11,829 $12,397 −5% $31,816 −63% —
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC $11,828 $11,828 $12,276 −4% $31,812 −63% —
975 HIV WITH MAJOR RELATED CONDITION WITH CC $11,732 $11,732 $11,895 −1% $25,010 −53% —
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC $11,714 $11,714 $12,041 −3% $21,615 −46% —
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $11,681 $11,681 $12,007 −3% $23,734 −51% —
088 CONCUSSION WITH MCC $11,644 $11,644 $11,968 −3% $24,402 −52% —
885 Psychoses $11,634 $11,634 $11,958 −3% $21,489 −46% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $11,630 $11,630 $12,188 −5% $29,757 −61% ≈134% of Medicare
811 RED BLOOD CELL DISORDERS WITH MCC $11,612 $11,612 $12,169 −5% $27,934 −58% ≈132% of Medicare
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC $11,595 $11,595 $11,918 −3% $35,542 −67% —
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC $11,566 $11,566 $11,888 −3% $24,452 −53% —
137 MOUTH PROCEDURES WITH CC/MCC $11,544 $11,544 $11,981 −4% $24,348 −53% —
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC $11,532 $11,532 $11,853 −3% $30,006 −62% —
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $11,500 $11,500 $11,500 +0% $25,666 −55% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $11,476 $11,476 $11,795 −3% $24,118 −52% —
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $11,469 $11,469 $11,903 −4% $24,561 −53% —
150 EPISTAXIS WITH MCC $11,408 $11,408 $11,841 −4% $21,133 −46% —
741 Uterine,adnexa proc for non-ovarian/adnexal malig w/o CC/MCC $11,337 $11,337 $11,881 −5% $29,050 −61% —
139 Salivary gland procedures $11,332 $11,332 $11,648 −3% $21,014 −46% —
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $11,311 $11,311 $11,626 −3% $20,980 −46% —
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC $11,309 $11,309 $11,624 −3% $30,418 −63% —
748 Female reproductive system reconstructive procedures $11,244 $11,244 $11,784 −5% $24,980 −55% —
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $11,185 $11,185 $11,609 −4% $29,374 −62% —
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $11,175 $11,175 $11,330 −1% $28,527 −61% —
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $11,114 $11,114 $11,648 −5% $23,723 −53% —
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC $11,081 $11,081 $11,390 −3% $29,805 −63% —
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $11,060 $11,060 $11,645 −5% $30,358 −64% ≈153% of Medicare
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $11,014 $11,014 $11,320 −3% $25,426 −57% ≈145% of Medicare
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC $11,004 $11,004 $11,310 −3% $31,978 −66% —
535 FRACTURES OF HIP AND PELVIS WITH MCC $10,977 $10,977 $11,503 −5% $23,350 −53% —
640 Nutritional & misc metabolic disorders w MCC $10,961 $10,961 $11,487 −5% $24,480 −55% ≈138% of Medicare
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $10,876 $10,876 $11,179 −3% $26,158 −58% ≈140% of Medicare
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC $10,875 $10,875 $11,178 −3% $34,887 −69% ≈146% of Medicare
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $10,826 $10,826 $10,976 −1% $23,115 −53% —
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $10,779 $10,779 $11,297 −5% $23,956 −55% —
291 HEART FAILURE AND SHOCK WITH MCC $10,769 $10,769 $11,286 −5% $25,020 −57% ≈137% of Medicare
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $10,762 $10,762 $11,062 −3% $21,029 −49% —
540 OSTEOMYELITIS WITH CC $10,681 $10,681 $11,086 −4% $23,494 −55% —
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC $10,652 $10,652 $10,801 −1% $22,811 −53% —
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $10,643 $10,643 $11,047 −4% $23,920 −56% —
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC $10,634 $10,634 $10,930 −3% $23,924 −56% —
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $10,631 $10,631 $10,927 −3% $24,316 −56% —
947 SIGNS AND SYMPTOMS WITH MCC $10,616 $10,616 $11,018 −4% $25,474 −58% —
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $10,602 $10,602 $10,897 −3% $27,244 −61% ≈141% of Medicare
796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC $10,537 $10,537 $11,094 −5% $22,557 −53% —
836 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CC/MCC $10,488 $10,488 $10,780 −3% $19,686 −47% —
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $10,488 $10,488 $10,780 −3% $22,275 −53% —
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC $10,468 $10,468 $10,760 −3% $28,156 −63% —
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC $10,457 $10,457 $10,748 −3% $25,623 −59% —
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $10,434 $10,434 $10,725 −3% $26,634 −61% —
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC $10,421 $10,421 $10,566 −1% $19,894 −48% —
348 ANAL AND STOMAL PROCEDURES WITH CC $10,391 $10,391 $10,889 −5% $27,947 −63% —
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $10,278 $10,278 $10,668 −4% $26,146 −61% —
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $10,277 $10,277 $10,663 −4% $19,354 −47% —
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $10,274 $10,274 $10,664 −4% $21,860 −53% —
642 Inborn errors of metabolism $10,244 $10,244 $10,529 −3% $20,727 −51% —
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $10,222 $10,222 $10,507 −3% $22,032 −54% ≈146% of Medicare
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $10,221 $10,221 $10,506 −3% $27,492 −63% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $10,213 $10,213 $10,497 −3% $25,704 −60% ≈141% of Medicare
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC $10,168 $10,168 $10,451 −3% $20,147 −50% —
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC $10,159 $10,159 $10,441 −3% $27,321 −63% —
375 DIGESTIVE MALIGNANCY WITH CC $10,141 $10,141 $10,526 −4% $27,219 −63% —
294 DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC $10,136 $10,136 $10,418 −3% $19,132 −47% —
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $10,099 $10,099 $10,380 −3% $26,322 −62% —
593 SKIN ULCERS WITH CC $10,092 $10,092 $10,474 −4% $20,470 −51% —
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC $10,062 $10,062 $10,444 −4% $23,588 −57% —
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC $10,019 $10,019 $10,399 −4% $23,297 −57% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $9,953 $9,953 $10,431 −5% $26,488 −62% ≈140% of Medicare
549 SEPTIC ARTHRITIS WITH CC $9,947 $9,947 $10,085 −1% $20,938 −52% —
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC $9,894 $9,894 $10,169 −3% $27,369 −64% —
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $9,865 $9,865 $10,139 −3% $20,421 −52% —
887 Other mental disorder diagnoses $9,817 $9,817 $10,090 −3% $20,602 −52% —
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC $9,779 $9,779 $10,150 −4% $20,842 −53% —
114 ORBITAL PROCEDURES WITHOUT CC/MCC $9,757 $9,757 $10,028 −3% $19,598 −50% —
304 HYPERTENSION WITH MCC $9,696 $9,696 $10,162 −5% $24,185 −60% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $9,659 $9,659 $9,928 −3% $22,982 −58% ≈140% of Medicare
302 ATHEROSCLEROSIS WITH MCC $9,602 $9,602 $10,062 −5% $20,844 −54% —
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $9,601 $9,601 $9,868 −3% $18,291 −48% —
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $9,600 $9,600 $9,867 −3% $21,062 −54% —
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC $9,581 $9,581 $9,848 −3% $22,532 −57% —
102 HEADACHES WITH MCC $9,570 $9,570 $10,029 −5% $22,544 −58% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $9,555 $9,555 $9,688 −1% $24,202 −61% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $9,537 $9,537 $9,899 −4% $25,307 −62% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $9,500 $9,500 $9,405 +1% $18,133 −48% —
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $9,440 $9,440 $9,798 −4% $25,390 −63% —
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $9,429 $9,429 $9,692 −3% $24,432 −61% —
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $9,399 $9,399 $9,755 −4% $24,452 −62% —
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC $9,394 $9,394 $9,394 +0% $25,267 −63% ≈161% of Medicare
152 OTITIS MEDIA AND URI WITH MCC $9,366 $9,366 $9,627 −3% $19,795 −53% —
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $9,309 $9,309 $9,661 −4% $20,741 −55% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $9,308 $9,308 $9,567 −3% $24,017 −61% —
399 APPENDIX PROCEDURES WITHOUT CC/MCC $9,276 $9,276 $9,534 −3% $30,314 −69% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $9,269 $9,269 $9,714 −5% $24,190 −62% ≈152% of Medicare
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $9,268 $9,268 $9,526 −3% $19,317 −52% —
946 REHABILITATION WITHOUT CC/MCC $9,215 $9,215 $9,323 −1% $17,685 −48% —
181 RESPIRATORY NEOPLASMS WITH CC $9,164 $9,164 $9,512 −4% $22,431 −59% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $9,162 $9,162 $9,602 −5% $18,459 −50% —
200 PNEUMOTHORAX WITH CC $9,141 $9,141 $9,580 −5% $20,573 −56% —
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC $9,125 $9,125 $9,379 −3% $24,544 −63% —
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC $9,101 $9,101 $9,354 −3% $25,162 −64% —
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC $9,087 $9,087 $9,346 −3% $17,483 −48% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $9,049 $9,049 $11,271 −20% $17,103 −47% —
672 URETHRAL PROCEDURES WITHOUT CC/MCC $9,033 $9,033 $8,828 +2% $17,398 −48% —
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $9,005 $9,005 $9,255 −3% $19,868 −55% —
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $8,994 $8,994 $9,426 −5% $31,190 −71% ≈173% of Medicare
381 COMPLICATED PEPTIC ULCER WITH CC $8,989 $8,989 $9,239 −3% $24,177 −63% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $8,951 $8,951 $9,291 −4% $21,806 −59% ≈142% of Medicare
784 CESAREAN SECTION WITH STERILIZATION WITH CC $8,939 $8,939 $12,774 −30% $22,560 −60% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $8,923 $8,923 $9,261 −4% $17,226 −48% —
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC $8,912 $8,912 $9,250 −4% $18,126 −51% —
949 AFTERCARE WITH CC/MCC $8,906 $8,906 $9,243 −4% $23,953 −63% —
598 MALIGNANT BREAST DISORDERS WITH CC $8,905 $8,905 $9,153 −3% $19,073 −53% —
117 INTRAOCULAR PROCEDURES WITHOUT CC/MCC $8,902 $8,902 $9,026 −1% $17,193 −48% —
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $8,881 $8,881 $9,128 −3% $17,943 −51% —
089 CONCUSSION WITH CC $8,849 $8,849 $8,849 +0% $18,293 −52% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $8,836 $8,836 $9,260 −5% $19,579 −55% ≈148% of Medicare
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $8,830 $8,830 $9,254 −5% $23,749 −63% —
712 TESTES PROCEDURES WITHOUT CC/MCC $8,828 $8,828 $8,951 −1% $18,898 −53% —
184 MAJOR CHEST TRAUMA WITH CC $8,816 $8,816 $9,061 −3% $20,842 −58% —
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $8,764 $8,764 $9,775 −10% $23,571 −63% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $8,756 $8,756 $9,000 −3% $23,496 −63% ≈165% of Medicare
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $8,738 $8,738 $9,069 −4% $24,136 −64% ≈144% of Medicare
071 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC $8,699 $8,699 $8,941 −3% $23,396 −63% ≈155% of Medicare
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $8,689 $8,689 $8,689 +0% $18,478 −53% —
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $8,682 $8,682 $8,924 −3% $17,550 −51% —
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $8,667 $8,667 $9,083 −5% $22,231 −61% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $8,604 $8,604 $8,843 −3% $23,141 −63% ≈145% of Medicare
644 ENDOCRINE DISORDERS WITH CC $8,529 $8,529 $8,939 −5% $22,941 −63% ≈136% of Medicare
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $8,510 $8,510 $8,918 −5% $22,781 −63% ≈149% of Medicare
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $8,496 $8,496 $8,732 −3% $22,850 −63% ≈143% of Medicare
667 PROSTATECTOMY WITHOUT CC/MCC $8,483 $8,483 $8,805 −4% $16,703 −49% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $8,473 $8,473 $8,880 −5% $24,022 −65% —
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC $8,458 $8,458 $8,779 −4% $16,495 −49% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $8,418 $8,418 $8,737 −4% $20,732 −59% ≈148% of Medicare
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $8,418 $8,418 $8,652 −3% $16,571 −49% —
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $8,416 $8,416 $8,651 −3% $21,545 −61% ≈143% of Medicare
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC $8,415 $8,415 $8,819 −5% $20,080 −58% —
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $8,413 $8,413 $8,732 −4% $19,091 −56% —
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $8,399 $8,399 $8,633 −3% $22,713 −63% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $8,393 $8,393 $8,711 −4% $23,469 −64% ≈158% of Medicare
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $8,387 $8,387 $8,620 −3% $18,017 −53% —
920 COMPLICATIONS OF TREATMENT WITH CC $8,385 $8,385 $8,787 −5% $21,181 −60% ≈132% of Medicare
187 PLEURAL EFFUSION WITH CC $8,287 $8,287 $8,517 −3% $21,467 −61% —
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $8,279 $8,279 $8,510 −3% $17,078 −52% —
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC $8,278 $8,278 $8,278 +0% $16,212 −49% —
697 Urethral stricture $8,269 $8,269 $8,499 −3% $17,705 −53% —
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $8,253 $8,253 $8,483 −3% $20,007 −59% —
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $8,237 $8,237 $10,576 −22% $15,370 −46% —
078 HYPERTENSIVE ENCEPHALOPATHY WITH CC $8,236 $8,236 $8,351 −1% $17,434 −53% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $8,192 $8,192 $8,420 −3% $20,968 −61% —
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $8,189 $8,189 $8,416 −3% $22,024 −63% ≈151% of Medicare
197 INTERSTITIAL LUNG DISEASE WITH CC $8,171 $8,171 $8,399 −3% $20,106 −59% —
378 GASTROINTESTINAL HEMORRHAGE WITH CC $8,137 $8,137 $8,364 −3% $21,886 −63% ≈145% of Medicare
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $8,135 $8,135 $8,361 −3% $18,282 −56% —
290 ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC $8,080 $8,080 $8,305 −3% $15,901 −49% —
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC $8,074 $8,074 $8,380 −4% $15,890 −49% —
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $7,991 $7,991 $8,598 −7% $19,001 −58% —
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $7,991 $7,991 $10,124 −21% $18,238 −56% —
202 BRONCHITIS AND ASTHMA WITH CC/MCC $7,979 $7,979 $8,281 −4% $17,273 −54% ≈156% of Medicare
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $7,975 $7,975 $8,357 −5% $21,449 −63% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $7,955 $7,955 $8,176 −3% $21,213 −62% ≈150% of Medicare
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $7,943 $7,943 $8,164 −3% $20,777 −62% ≈156% of Medicare
882 Neuroses except depressive $7,940 $7,940 $8,241 −4% $15,680 −49% —
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $7,912 $7,912 $8,292 −5% $15,636 −49% —
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC $7,896 $7,896 $8,195 −4% $16,418 −52% —
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $7,891 $7,891 $8,111 −3% $18,191 −57% —
670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC $7,888 $7,888 $8,108 −3% $20,371 −61% —
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC $7,884 $7,884 $8,103 −3% $19,326 −59% —
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $7,882 $7,882 $8,181 −4% $15,589 −49% —
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC $7,856 $7,856 $8,075 −3% $18,428 −57% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $7,769 $7,769 $7,986 −3% $18,918 −59% ≈149% of Medicare
158 DENTAL AND ORAL DISEASES WITH CC $7,763 $7,763 $7,980 −3% $17,700 −56% —
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC $7,756 $7,756 $8,050 −4% $17,108 −55% —
779 ABORTION WITHOUT D&C $7,716 $7,716 $7,930 −3% $15,327 −50% —
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $7,706 $7,706 $7,998 −4% $16,642 −54% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $7,646 $7,646 $7,859 −3% $18,608 −59% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $7,624 $7,624 $7,990 −5% $19,287 −60% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $7,617 $7,617 $7,983 −5% $20,488 −63% ≈149% of Medicare
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $7,608 $7,608 $7,820 −3% $20,463 −63% ≈152% of Medicare
101 SEIZURES WITHOUT MCC $7,607 $7,607 $7,819 −3% $19,954 −62% ≈144% of Medicare
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC $7,605 $7,605 $7,893 −4% $20,309 −63% —
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC $7,585 $7,585 $7,873 −4% $16,352 −54% —
638 DIABETES WITH CC $7,570 $7,570 $7,934 −5% $18,821 −60% ≈159% of Medicare
076 VIRAL MENINGITIS WITHOUT CC/MCC $7,568 $7,568 $7,779 −3% $15,474 −51% —
914 TRAUMATIC INJURY WITHOUT MCC $7,564 $7,564 $7,850 −4% $15,593 −51% —
881 Depressive neuroses $7,545 $7,545 $7,831 −4% $15,058 −50% —
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $7,532 $7,532 $7,742 −3% $17,585 −57% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $7,476 $7,476 $7,835 −5% $17,731 −58% —
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $7,468 $7,468 $7,676 −3% $15,077 −50% —
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC $7,467 $7,467 $8,017 −7% $20,084 −63% —
864 FEVER AND INFLAMMATORY CONDITIONS $7,412 $7,412 $7,618 −3% $17,412 −57% ≈150% of Medicare
563 Fx, sprn, strn & disl except femur, hip, pelvis & thigh w/o MCC $7,377 $7,377 $7,583 −3% $18,803 −61% ≈156% of Medicare
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC $7,366 $7,366 $7,571 −3% $21,261 −65% —
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC $7,361 $7,361 $7,566 −3% $15,764 −53% —
683 RENAL FAILURE WITH CC $7,337 $7,337 $7,689 −5% $18,620 −61% ≈152% of Medicare
866 VIRAL ILLNESS WITHOUT MCC $7,303 $7,303 $7,506 −3% $16,391 −55% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $7,301 $7,301 $7,504 −3% $15,045 −51% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $7,296 $7,296 $7,499 −3% $15,869 −54% —
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $7,288 $7,288 $7,491 −3% $15,608 −53% —
897 Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o MCC $7,281 $7,281 $7,484 −3% $16,049 −55% ≈143% of Medicare
068 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $7,276 $7,276 $7,478 −3% $19,569 −63% —
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC $7,271 $7,271 $7,620 −5% $19,854 −63% —
603 CELLULITIS WITHOUT MCC $7,270 $7,270 $7,472 −3% $18,530 −61% ≈164% of Medicare
541 OSTEOMYELITIS WITHOUT CC/MCC $7,221 $7,221 $7,495 −4% $14,549 −50% —
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $7,210 $7,210 $10,545 −32% $19,815 −64% —
312 SYNCOPE AND COLLAPSE $7,191 $7,191 $7,537 −5% $19,342 −63% ≈153% of Medicare
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $7,177 $7,177 $7,377 −3% $19,305 −63% —
607 MINOR SKIN DISORDERS WITHOUT MCC $7,133 $7,133 $7,475 −5% $15,284 −53% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $7,130 $7,130 $7,328 −3% $17,367 −59% —
550 SEPTIC ARTHRITIS WITHOUT CC/MCC $7,116 $7,116 $7,314 −3% $16,156 −56% —
292 HEART FAILURE AND SHOCK WITH CC $7,108 $7,108 $7,306 −3% $16,212 −56% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $7,100 $7,100 $7,369 −4% $19,096 −63% ≈161% of Medicare
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $7,091 $7,091 $7,431 −5% $18,278 −61% ≈167% of Medicare
090 CONCUSSION WITHOUT CC/MCC $7,076 $7,076 $7,344 −4% $14,873 −52% —
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $7,056 $7,056 $7,253 −3% $14,290 −51% —
103 HEADACHES WITHOUT MCC $7,017 $7,017 $7,213 −3% $20,111 −65% —
594 SKIN ULCERS WITHOUT CC/MCC $7,005 $7,005 $7,271 −4% $14,209 −51% —
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC $6,912 $6,912 $7,131 −3% $14,064 −51% —
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC $6,907 $6,907 $7,169 −4% $14,055 −51% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $6,889 $6,889 $7,219 −5% $18,253 −62% ≈164% of Medicare
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $6,815 $6,815 $7,073 −4% $15,876 −57% —
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $6,768 $6,768 $7,093 −5% $18,204 −63% ≈169% of Medicare
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $6,759 $6,759 $7,015 −4% $13,822 −51% —
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $6,748 $6,748 $6,936 −3% $18,150 −63% —
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $6,744 $6,744 $6,744 +0% $16,837 −60% —
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $6,739 $6,739 $6,927 −3% $17,715 −62% —
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC $6,739 $6,739 $6,927 −3% $17,928 −62% —
176 PULMONARY EMBOLISM WITHOUT MCC $6,723 $6,723 $7,045 −5% $18,081 −63% ≈172% of Medicare
534 FRACTURES OF FEMUR WITHOUT MCC $6,719 $6,719 $6,906 −3% $17,195 −61% —
138 MOUTH PROCEDURES WITHOUT CC/MCC $6,714 $6,714 $6,969 −4% $17,383 −61% —
204 RESPIRATORY SIGNS AND SYMPTOMS $6,694 $6,694 $7,015 −5% $16,866 −60% —
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $6,693 $6,693 $6,879 −3% $18,002 −63% ≈189% of Medicare
123 Neurological eye disorders $6,629 $6,629 $6,881 −4% $17,831 −63% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $6,624 $6,624 $6,809 −3% $17,466 −62% ≈172% of Medicare
389 GASTROINTESTINAL OBSTRUCTION WITH CC $6,616 $6,616 $6,800 −3% $17,388 −62% ≈181% of Medicare
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC $6,609 $6,609 $6,793 −3% $13,586 −51% —
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $6,604 $6,604 $6,696 −1% $20,278 −67% ≈171% of Medicare
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $6,581 $6,581 $6,896 −5% $17,700 −63% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $6,558 $6,558 $6,872 −5% $17,727 −63% ≈161% of Medicare
295 DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC $6,519 $6,519 $6,267 +4% $13,445 −52% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $6,515 $6,515 $6,762 −4% $17,522 −63% —
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC $6,481 $6,481 $6,661 −3% $13,385 −52% —
641 Nutritional & misc metabolic disorders w/o MCC $6,449 $6,449 $6,629 −3% $16,745 −61% ≈182% of Medicare
694 URINARY STONES WITHOUT MCC $6,449 $6,449 $6,629 −3% $16,531 −61% —
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $6,440 $6,440 $6,685 −4% $17,322 −63% ≈186% of Medicare
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $6,427 $6,427 $6,671 −4% $14,166 −55% —
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC $6,419 $6,419 $6,727 −5% $15,858 −60% —
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $6,353 $6,353 $6,594 −4% $14,444 −56% —
151 EPISTAXIS WITHOUT MCC $6,256 $6,256 $6,494 −4% $13,032 −52% —
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC $6,237 $6,237 $6,537 −5% $16,776 −63% —
305 HYPERTENSION WITHOUT MCC $6,196 $6,196 $6,493 −5% $17,144 −64% ≈190% of Medicare
072 NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $6,192 $6,192 $6,364 −3% $16,654 −63% —
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC $6,185 $6,185 $6,357 −3% $16,634 −63% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $6,175 $6,175 $6,409 −4% $14,337 −57% —
149 Dysequilibrium $6,170 $6,170 $6,256 −1% $17,203 −64% —
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $6,169 $6,169 $6,341 −3% $12,895 −52% —
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $6,159 $6,159 $6,330 −3% $14,861 −59% —
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $6,144 $6,144 $6,315 −3% $13,892 −56% —
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $6,116 $6,116 $6,286 −3% $13,282 −54% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $6,102 $6,102 $6,333 −4% $16,865 −64% ≈189% of Medicare
188 PLEURAL EFFUSION WITHOUT CC/MCC $6,060 $6,060 $6,229 −3% $14,110 −57% —
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $6,014 $6,014 $6,242 −4% $12,650 −52% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC $5,987 $5,987 $6,154 −3% $16,104 −63% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $5,985 $5,985 $6,272 −5% $18,623 −68% —
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $5,977 $5,977 $6,144 −3% $12,593 −53% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $5,972 $5,972 $9,343 −36% $13,090 −54% —
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC $5,939 $5,939 $6,105 −3% $12,537 −53% —
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $5,889 $5,889 $6,053 −3% $12,381 −52% —
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $5,888 $5,888 $6,171 −5% $15,607 −62% —
313 Chest pain $5,888 $5,888 $6,171 −5% $15,962 −63% —
153 OTITIS MEDIA AND URI WITHOUT MCC $5,874 $5,874 $6,038 −3% $14,473 −59% —
297 CARDIAC ARREST, UNEXPLAINED WITH CC $5,814 $5,814 $5,976 −3% $12,336 −53% —
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC $5,800 $5,800 $6,020 −4% $15,600 −63% —
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC $5,781 $5,781 $6,058 −5% $13,654 −58% —
311 Angina pectoris $5,764 $5,764 $5,924 −3% $15,165 −62% —
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC $5,761 $5,761 $5,921 −3% $15,072 −62% —
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $5,750 $5,750 $6,025 −5% $12,279 −53% —
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC $5,749 $5,749 $5,829 −1% $12,405 −54% —
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $5,730 $5,730 $5,889 −3% $13,303 −57% —
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $5,710 $5,710 $5,984 −5% $14,441 −60% —
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $5,681 $5,681 $5,839 −3% $19,483 −71% —
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC $5,676 $5,676 $5,948 −5% $14,012 −59% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $5,635 $5,635 $5,792 −3% $12,797 −56% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC $5,598 $5,598 $5,754 −3% $11,997 −53% —
201 PNEUMOTHORAX WITHOUT CC/MCC $5,589 $5,589 $5,857 −5% $13,081 −57% —
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $5,550 $5,550 $5,760 −4% $13,198 −58% —
303 ATHEROSCLEROSIS WITHOUT MCC $5,550 $5,550 $5,704 −3% $14,927 −63% —
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC $5,542 $5,542 $5,697 −3% $11,909 −53% —
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $5,532 $5,532 $5,798 −5% $14,880 −63% —
079 HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC $5,503 $5,503 $5,589 −2% $11,847 −54% —
916 ALLERGIC REACTIONS WITHOUT MCC $5,481 $5,481 $5,634 −3% $13,890 −61% —
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $5,444 $5,444 $5,651 −4% $13,368 −59% —
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $5,443 $5,443 $5,704 −5% $13,485 −60% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $5,342 $5,342 $5,598 −5% $14,368 −63% —
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $5,282 $5,282 $5,562 −5% $14,208 −63% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $5,260 $5,260 $8,897 −41% $12,044 −56% —
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $5,255 $5,255 $5,559 −5% $14,134 −63% ≈247% of Medicare
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $5,253 $5,253 $5,399 −3% $14,128 −63% —
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $5,232 $5,232 $5,483 −5% $11,421 −54% —
639 DIABETES WITHOUT CC/MCC $5,172 $5,172 $5,316 −3% $13,910 −63% —
894 Alcohol/drug abuse or dependence, left AMA $5,151 $5,151 $5,424 −5% $12,013 −57% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $5,140 $5,140 $5,283 −3% $13,824 −63% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $5,077 $5,077 $5,370 −5% $15,070 −66% —
684 RENAL FAILURE WITHOUT CC/MCC $5,013 $5,013 $5,153 −3% $13,623 −63% ≈225% of Medicare
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $5,009 $5,009 $5,274 −5% $11,071 −55% —
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $4,948 $4,948 $5,186 −5% $10,975 −55% —
950 AFTERCARE WITHOUT CC/MCC $4,838 $4,838 $5,117 −5% $13,527 −64% —
951 Other factors influencing health status $4,680 $4,680 $4,950 −5% $9,385 −50% —
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC $4,634 $4,634 $4,763 −3% $10,039 −54% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $4,618 $4,618 $4,793 −4% $13,384 −65% ≈254% of Medicare
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC $4,529 $4,529 $4,790 −5% $11,955 −62% —
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $4,516 $4,516 $4,642 −3% $13,318 −66% ≈242% of Medicare
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $4,290 $4,290 $4,496 −5% $9,076 −53% —
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC $3,646 $3,646 $3,989 −9% $8,927 −59% —
795 Normal newborn $1,649 $1,649 $3,492 −53% $4,530 −64% —

Procedures with negotiated rates only

These 21 procedures have published per-payer insurance agreements but no single comparable dollar amount in the MRF — typically because the agreement is expressed as a percentage of charge, a fee schedule reference, or a contract algorithm. The number of payers indicates how many insurance plans have a negotiated rate on file.

DRG Description Insurance rate range Payers
222 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITH MCC $63,944 – $63,944 · median $63,944 2 plans
223 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITHOUT MCC $47,170 – $47,170 · median $47,170 2 plans
224 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITH MCC $55,903 – $55,903 · median $55,903 2 plans
225 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITHOUT MCC $42,726 – $42,726 · median $42,726 2 plans
226 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITH MCC $50,205 – $50,205 · median $50,205 2 plans
227 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $39,879 – $39,879 · median $39,879 2 plans
246 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS $23,734 – $23,734 · median $23,734 2 plans
247 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC $15,097 – $15,097 · median $15,097 2 plans
248 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS $24,100 – $24,100 · median $24,100 2 plans
249 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITHOUT MCC $14,270 – $14,270 · median $14,270 2 plans
338 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC $21,252 – $21,252 · median $21,252 2 plans
339 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH CC $12,871 – $12,871 · median $12,871 2 plans
340 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $9,328 – $9,328 · median $9,328 2 plans
341 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC $17,587 – $17,587 · median $17,587 2 plans
342 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH CC $10,882 – $10,882 · median $10,882 2 plans
343 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $8,424 – $8,424 · median $8,424 2 plans
453 Combined anterior/posterior spinal fusion w MCC $69,809 – $69,809 · median $69,809 2 plans
454 Combined anterior/posterior spinal fusion w CC $46,304 – $46,304 · median $46,304 2 plans
455 Combined anterior/posterior spinal fusion w/o CC/MCC $36,379 – $36,379 · median $36,379 2 plans
459 SPINAL FUSION EXCEPT CERVICAL WITH MCC $51,116 – $51,116 · median $51,116 2 plans
460 SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $29,862 – $29,862 · median $29,862 2 plans
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